Healthcare Contracts Manager
About The Position
The Healthcare Contracts Manager plays a key role in advancing the organization’s mission by leading the negotiation, development, and management of payer contracts, collaborative agreements, and service partnerships with healthcare entities. This position will collaborate with executive leadership, finance, and clinical teams to develop and maintain contracting strategies that drive organizational growth, optimize reimbursement for high-cost therapies, and secure favorable terms for new service lines or partnerships, operational effectiveness, and high‑quality care delivery across the organization’s programs.
Requirements
- Bachelor’s degree in a related field, or equivalent combination of education and experience
- 3–5+ years of experience in negotiating complex agreements with payers, PBMs, and healthcare vendors
- Strong understanding of Washington State healthcare regulations, reimbursement models, managed care structures, and healthcare regulatory requirements
- Thorough knowledge of Medicare, Medicaid and other governmental insurance regulations and CMS claims form
- Strong command of current coding standards (CPT, HCPCS, ICD-10) and their impact on reimbursement modeling
- Ability to interpret complex contract language and translate it into operational requirements
- Excellent negotiation, communication, and relationship building skills
- Strong organization skills
- Ability to maintain confidentiality per HIPAA requirements
- Experience with Microsoft office/365
Nice To Haves
- Preference for experience in proactive payer outreach, network expansion, or business development in specialty/rare disease healthcare. Proven success building and closing complex PBM or payer contracts.
- Understanding of 340B program requirements and pharmacy contracting preferred
- Exceptional analytical skills, mathematical/accounting ability sufficient to support the management of the insurance billing and accounting systems
- Experience with Hemophilia Treatment Centers (HTC) or high-cost specialty pharmacy contracting is a plus.
Responsibilities
- Proactively identify and pursue opportunities to establish and maintain payer contracts, network inclusions, and partnerships with commercial insurers, PBMs, medical coverage plans, self-insured employers, and local businesses to expand WACBD's in-network provider status and increase patient access/revenue streams.
- Lead negotiation, drafting, execution and maintenance of payer contracts
- Oversee proper entry of contract rates into organizational databases and ensure they are securely maintained.
- Analyze contract terms, reimbursement methodologies, and regulatory requirements to ensure alignment with organizational goals and compliance standards.
- As needed, aid the Pharmacy Director to review and negotiate contracts related to 340B pharmacy operations, including specialty pharmacy distribution, replenishment models, and third-party arrangements.
- Manage and update office of Pharmacy Affairs 340B Database.
- Develop and manage collaborative agreements, MOUs, and service contracts with hospitals, clinics, community partners, and other healthcare and community organizations.
- Ensure all contracts adhere to federal and state regulations, including 340B, HIPAA, Medicaid/Medicare requirements, and Washington State healthcare laws. Partner with clinical, pharmacy, finance, compliance/legal, and administrative teams to understand operational needs and translate them into effective contract structures.
- A full job description will be made available to candidates before they interview with the hiring manager
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Manager
Number of Employees
11-50 employees
